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Biomedical subjects

R E Madden

Publications and source records attributed to R E Madden.

At least 19 recordsLinked to original sources

Pulmonary scar carcinoma: report of three cases and review of the literature.

Pulmonary scar carcinoma was described as a distinct clinicopathological entity over 50 years ago. There are many theories on the formation of this entity. We present three cases of pulmonary scar carcinoma with a high ratio of adenocarcinoma. One patient had a favorable postoperative course despite a 14-month delay in treatment. Necropsy specimen of another patient showed two primary scar carcinomas unrelated to each other. Literature review and discussion of etiology, diagnosis, and treatment modalities of pulmonary scar carcinoma were done. Pathogenesis and prognosis of the neoplasms associated with apical scars are not clearly understood.

Adenocarcinoma↗

Distal thigh/arm index as a predictor of success for lumbar sympathectomy.

Data from 90 lumbar sympathectomies were reviewed to assess the role of a distal thigh/arm Doppler systolic index (DTAI) and of external magnetic flowmeter (MCBF) measurements for predicting patient outcome following lumbar sympathectomy. The presenting symptoms included impending gangrene, gangrene, rest pain, nonhealing ulcers, and disabling claudication. Of the 90 cases, clinical improvement occurred in 57% of the limbs. Major amputation was not required in 73% of the limbs. The MCBF data showed variability which masked the relationship to the effects of sympathectomy. DTAI test results were significantly related to outcome. For DTAI > 0.6 (57 patients), improvement occurred in 70% of the limbs, with major amputation not required in 86% of the limbs. For DTAI < 0.6 (33 patients), improvement occurred in only 33% of the limbs, and major amputation was not required in 52% of the limbs. The Doppler systolic index has provided a noninvasive measure that can be used in conjunction with good clinical judgment for predicting the outcome of lumbar sympathectomy.

Amputation, Surgical↗

Attitudes of medical students and faculty toward cancer.

The Cancer Attitude Survey (CAS) was administered to second year students before, during, and after a year-long "Introduction to Clinical Medicine" course. The course contained a 14-hour oncology segment. Faculty of the Clinical Medicine Course and nonclinical faculty teaching oncology related topics also responded to the CAS. The CAS contains four scales: Attitudes toward: I, the patient's inner resources to cope with cancer; IIA, the value of early diagnosis; IIB, aggressive treatment; and III, personal immortality and preparation for and acceptance of death. At the beginning of the course, student attitudes were positive; there was no change in attitudes across the three testing periods. Among faculty, dedicated oncologists had the most positive attitudes; students and nononcology clinical faculty exhibited similar trends in attitudes; nonclinical faculty teaching oncology related material had least positive attitudes.

Attitude of Health Personnel↗

Malignant schwannoma of the vagus nerve: a case report and review of the literature.

A case of neuroectodermal tumor, a malignant schwannoma, of the cervical vagus nerve is presented. It had been previously misdiagnosed and was a recurrence. A review of the literature reveals this to be the sixth such case reported. The difficulties in establishing a diagnosis and the principals of adequate therapy are discussed; these include wide surgical resection and postoperative radiotherapy to the tumor bed. The correct recognition of their malignant potential is essential for long-term disease-free survival.

Adult↗

Yoshi 864 (1-propanol, 3,3'-iminodi-, dimethanesulfonate [ester], hydrochloride): a phase II study in solid tumors.

Two hundred and eight acceptable patients were treated with Yoshi 864 (2 mg/kg/day by iv push X 5 days repeated once every 6 weeks). Toxicity was minimal. There was an overall response rate of 11%. Cross resistance with other alkylating agents may not be present. Because of its lack of toxicity, Yoshi 864 should be further evaluated in chronic myelocytic leukemia, lymphomas, and carcinomas of the ovary and bladder where significant responses were seen. It should also be evaluated in combinations as a replacement for other alkylating agents which cause more nausea and vomiting.

Alkylating Agents↗

Combination chemotherapy in breast cancer: a randomized study of 4 versus 5 drugs.

A randomized clinical trial, involving approximately 100 patients, that compared two combination therapy regimens (5 FU, methotrexate, vincristine, cyclophosphamide with and without prednisone) in advanced breast cancer showed a significantly higher rate of response for the 5-drug therapy group (62.5 versus 44.2%). However, no significant difference in survival has been observed to date. Some differences in toxicity were observed, e.g. a significantly greater number of cases with mild diarrhea for the 5-drug regimen, and a few more cases of sensory loss (not significant) and significantly more severe leukopenia (p value 0.06) for the 4-drug regimen.

Breast Neoplasms↗